Memory loss

Memory and Communication

Introduction

My Dad would often mention a visitor he’d had, but he was never sure who it was. So I put out a “visitors’ book” and asked people to sign in. It turned out that the mystery person was his care worker.

There were nights when he would wake us up playing the piano. He didn’t know his own children, but he could still play the most complicated pieces. At times like that I would question my own sanity.

Sometimes my partner goes back in his mind to when he was working and gets anxious about getting to work on time. At first, I would tell him that he doesn’t work any more but he’d insist he does and we’d end up arguing. So now I reassure him that it’s all right, he doesn’t have to go to work today.

Memory loss is one of the most common symptoms of Alzheimer’s disease. It is often the first sign which leads people to suspect that there is a problem and seek medical advice. However, it is important to realise that people tend to lose their memory gradually rather than all at once.

There are a few different kinds of memory loss. With Alzheimer’s disease, the memory for recent events tends to be affected most, with long term memories persisting for many years after the onset of the disease. You may have noticed, for example, that people with dementia can remember something they did years ago but cannot remember having already had lunch. You might have also noticed how memory loss interferes with daily routine tasks and even having a conversation. In fact, one of the key features of memory impairment is the inability to learn. Certain kinds of memory loss may be upsetting to you (e.g. when they forget your name) or worrying (e.g. when they forget to turn off the gas). However, it can be extremely disturbing for them too. It can be a source of confusion, humiliation and shame. In the early stages in particular, they may try to hide some of the consequences of memory loss out of embarrassment or shame. Later on, they may be less aware of memory problems, but still suffer the consequences, such as loss of independence and frustration.

Fortunately, carers can provide valuable practical assistance to the person with dementia, as well as emotional support. This can help reduce the negative consequences of memory loss. You may even find that you become closer to the person and more involved in his or her life. But it is important to try to accept that your daily life will change. Things will not be like they used to be.

How to cope with memory loss

Maintain a positive attitude and provide reassurance

When trying to resolve a problem caused by memory loss, it is important to try to bear in mind not only the mistake or problem, but also how the person with dementia might feel as a consequence. Forgetting where the cups are kept, for example, is not really a problem as someone can easily show where they are, but the person with dementia could feel embarrassed, useless, angry or frustrated about it. Other kinds of memory loss may be accompanied by different emotions. Sometimes, you might feel that the person is being deliberately awkward or inconsiderate. It is very important to remember that their behaviour is a consequence of the disease.

Avoid drawing unnecessary attention to mistakes

It is often unnecessary to draw attention to mistakes. For example, when you are talking to someone with dementia, they may use an inappropriate word because they cannot remember the correct one. You may feel inclined to correct the person or even do so automatically. However, if you have understood what they were trying to say, this is unnecessary and also likely to make them feel uneasy, embarrassed or annoyed.

Reminders and markers

It may help, particularly in the early stages of the disease, occasionally to remind the person with dementia what to do, what is going on and who people are, etc. However, it is important not to do this to such an extent that it appears unnatural, draws unnecessary attention to the problem or is embarrassing. Apart from visual aids, it might help to use markers such as a diary, notice board, signs on doors, post-it stickers on the fridge, calendars (mark off days), clocks (with a clear face and loud tick), photographs (with names marked below) or a visitors’ book.

How to prevent problems due to memory loss

A stable environment and routines

As people with dementia lose the ability to learn due to memory loss, it is best to adapt the situation or surroundings to their needs, rather than trying to teach them how to adapt to their own changing abilities. For example, if the person with dementia tends to forget to turn off the tap, you could perhaps have a device fitted which allows only a certain amount of water to come out at any one time. However, try to keep changes to the minimum and concentrate on creating a stable environment that the person can count on.

Daily routines can also help the person to cope. It might sound monotonous to always do things in the same order, but for someone with dementia this can help prevent anxiety, avoid confusion and help the person to concentrate their time and efforts on other things.

Information on memory loss in particular situations

Many problems encountered by people with dementia are linked to memory loss in some way, e.g. forgetting to wash, to eat, how to get dressed, where the toilet is, etc. For this reason, they are dealt with in detail in the following chapters (i.e. on personal hygiene, eating and drinking and incontinence, etc.).